Instructions: Place a hard armless chair against a wall. The
following maneuvers are tested.

1. Sitting down

unable without help or collapses (plops) into chair or lands off center of chair Able and does not meet criteria for first or lastSits in a smooth, safe motion and ends with buttocks against back of chair and thighs centered on chair

2. Sitting balance

Unable to maintain position (marked slide forward or leans forward or to side) Leans in chair slightly or slight increased distance from buttocks to back of chairSteady, safe, upright

3. Arising

Unable without help or loses balance or requires >three attempts Able but requires three attempts Able in = two attempts

4. Immediate standing balance (first 5 seconds)

Unsteady, marked staggering, moves feet, marked trunk sway or grabs object for support Steady but uses walker or cane or mild staggering but catches self without grabbing object Steady without walker or cane or other support

5. (Stand) side-by-side standing balance

Unable or unsteady or holds =3 seconds Able but uses cane, walker, or other support or holds for 4–9 secondsNarrow stance without support for 30 seconds

6. Pull test (person at maximum position attained in
#5, examiner stands behind and exerts mild pull back at waist)

Begins to fall Takes more than two steps back Fewer than two steps backward and steady

7. Able to stand on right leg unsupported

Unable or holds onto any objects or able for <3 secondsAble for 3 or 4 seconds Able for 5 seconds

8. Able to stand on left leg unsupported

Unable or holds onto any object or able for <3 seconds Able for 3 or 4 seconds Able for 5 seconds

9. Semitandem stand

Unable to stand with one foot half in front of other with feet touching or begins to fall or holds for =3 secondsAble for 4 to 9 seconds Able to semitandem stand for 30 seconds

10. Tandem stand

Unable to stand with one foot in front of other or begins to fall or holds for =3 seconds Able for 4 to 9 secondsAble to tandem stand for 30 seconds

11. Bending over (to pick up a pen off floor)

Able and is steady Able, but requires more than one attempt to get up Unable or is unsteady

12. Toe stand

Able for 3 seconds Able but <3 seconds Unable

13. Heel stand

Able for 3 seconds Able but <3 seconds Unable

Gait:
Instructions: Person stands with examiner, walks down 30-ft walkway (measured).
Ask the person to walk down walkway, turn, and walk back. The person should use
customary walking aid.

18. Step over obstacles (to be assessed in a separate
walk with two shoes placed on course 4 feet apart)

Begins to fall at any obstacle or unable or walks around any obstacle or >two missed steps Able to step over all obstacles, but some staggering and catches self or one to two missed steps Able and steady at stepping over all four obstacles with no missed steps

The low common variance found between ankle ROM (Range of
Motion) measurements and the Performance- Oriented Mobility
Assessment (POMA) balance subtest scores indicates to us that ankle ROM may be
relatively less important in these activities. During the maneuvers of the POMA
balance subtest, including sitting, standing, and standing with eyes closed,
other factors may be more critical in influencing balance, but our study was
correlational and interventions were outside the scope of this study.

Conclusion

We found that a relationship exists between ankle ROM and performance on balance
tests in community-dwelling elderly women with no health problems. Ankle
exercises directed at increasing ankle ROM may increase the effectiveness of
clinical and community interventions designed for improving balance and
reducing falls in elderly women. Our results can provide information to those
developing interventions and investigating treatment efficacy because they
suggest that interventions for increasing ankle ROM may have an influence on
reducing falls in this population.